Chitosan has fascinating antibacterial activity, good biodegradation, outstanding biocompatibility, non-toxicity and excellent physical and chemical properties. As a result, chitosan has been widely used in the field of antibacterial. Chitosan and its derivatives show antibacterial activity against fungi, gram-positive bacteria and gram-negative bacteria. In recent years, there have been some reviews about the antibacterial activity of chitosan and its derivatives. This review adds many valuable concerns on the basis of those previous reviews. For example, composite of chitosan and metal, composite of chitosan and metal oxide, etc. This review will systematically analyze various influencing factors of chitosan, so as to clearly summarize the antibacterial mechanism of chitosan. Finally, the challenges and prospects of chitosan-based materials as antimicrobial agents are assessed and commented.